Good Medicine - Senior Year
Copyright © 2015-2023 Penguintopia Productions
Chapter 22: A Pair of Questions
September 20, 1984, Milford, Ohio
"Thanks for coming here, Mike," Doctor Mercer said when I walked into her office.
"I felt I had to. Clarissa and Sandy are at Frisch's, and I'll join them when we're done. They know it could be a while."
"Have a seat," she invited.
Instead of sitting down, I went to the couch, took off my shoes, lay down, and stretched out. Doctor Mercer got up and moved to the chair, which was positioned just behind my head.
"This is different," Doctor Mercer observed.
"I know," I replied. "But I was pretty stressed, and it hasn't gone away."
"I could tell when you called me, and that's the primary reason I wanted you to come here. Angie is the secondary one, of course. Take me through what happened."
"Basically, we had a nice chat, and I told her I was very likely going to get engaged, and the wedding would be next Summer. She didn't react badly, though I could tell she was somewhat sad. Her reaction was really what I expected, at least at first — that she regretted how things had turned out between us because of her condition, and she apologized and expressed regret. In other words, she was the same Angie I remember from between that French kiss and what I call her first meltdown."
"And that's exactly what I would have expected. What happened next?"
"She told me she wanted to have a husband and kids, which at that point I took to be me, and said she needed help getting past her mental block. I knew what she meant and voiced a gentle objection, and that's when she asked me to help her. I told her I didn't know if I could, but she persisted. And that's when I realized what it was she wanted from me. It wasn't a marriage but a chance to be normal. And she felt making love with me would give her that chance."
"We'll come back to that in a moment, but I want to ask you about what you said about not seeing you as her husband."
"I think, once I told her I was going to get engaged, something she said she expected, it kind of put the final point on something she'd concluded — she couldn't be my wife, even if she was past her mental block, because she was too emotionally fragile. She didn't say it, but in a sense, she realized the same thing Tasha did — I can't provide the kind of emotional support necessary for a proper relationship with either of them because of me, but also because of their needs."
"You think she understands that?"
"Maybe not in a logical way, but I think intuitively or subconsciously, she does. Remember, she spent a lot of time with me when I was obsessed with my coursework and the difficulties of the path I'd chosen to walk. She was certainly lucid both then and now, and I think even if she can't articulate it logically, she knows — she doesn't have the strength to be married to me, given my future. The same conclusion Tasha reached."
"So, having concluded you can't be a couple, Angie asked you to make love with her to get her past her mental block?"
I nodded, "She did."
"And you realize just how dangerous that would be?"
"Not just for her, Doc," I replied.
"Then why in Heaven's name did you tell me on the phone that you were actually considering it?!"
"I am lying here, on your couch, Doc, not in her bed," I protested weakly.
"Yes, that's true. But how could you even consider such a thing?"
"Because I love her; I have since not long after I met her. I want to help her. I want her to have the things she wants."
"Mike, you simply can't expect a casual encounter to help her get past her mental block! It could drive her to all sorts of terrible reactions and might result in her being institutionalized or contemplating suicide, and likely succeeding if intervention wasn't swift."
"First of all," I replied calmly, "making love with Angie would be anything but casual. And that's part of my problem, assuming we set aside the whole concern about sinful behavior, which is its own thicket. Second, what if it worked? What IF Angie could have some kind of normal life with a husband and kids? What IF this got her past the mental block to the point where she was cured?"
"What if she ends up permanently committed to a psychiatric facility or on a cold steel table in a morgue?"
"I know," I replied. "As I said, there's a reason I'm lying here and not with her."
"I counseled a young woman who had something of a similar relationship. The facts are different, but the basic concept is similar — she had a friend who was helping her recover from a traumatic experience, which made intimacy very difficult. She convinced him to do what Angie asked you to do, and it backfired badly. Not in the sense of a mental breakdown, but what was supposed to be a single encounter led to her falling in love and creating all sorts of complications in both their lives. She's having serious trouble with having ANY relationship with anyone but him, and he's basically involved with someone else. Sound familiar?"
"You think Angie would decide she wants to marry me?"
"I think we both know she does, despite what you said earlier. I do agree with you that given everything you've told me about your future, you could not care for a wife who had a condition similar to Angie's."
"But if it were cured..."
"If wishes were horses, beggars would ride."
"Can we talk about this idea in a general way?"
"Sure."
"This sounds like one of those proverbial cases of the 'cure is worse than the disease' because you think the risks associated with the cure are too great."
"Yes, and you'll encounter those kinds of situations in your career where doing nothing is actually the best choice. I think oncology provides some very instructive cases — chemotherapy and radiation are brutal on the body, and you have to evaluate if it's better for the patient to have a good six months or a terrible three years, or whatever. Those decisions aren't easy."
"But isn't that up to the patient and their family to evaluate the options and determine what's best for them?"
"Yes, but taking a step away from oncology, there will be cases where the patient can live with the issue and surgery, or whatever, is risky. Would, for example, a 50-50 chance of a negative outcome be worth it if, whatever the disease was, happened to be merely slightly debilitating?"
"I guess it would depend on the circumstances. An athlete might take that 50-50 shot if doing nothing limited their career. But again, that's up to them to decide, with input from the physicians and family. In this case, Angie doesn't see herself as complete and believes a future where she is married and has kids is worth the risk."
"I'm not sure she's evaluating the risk properly, nor do I think you are."
"There are no guarantees in life, Doc. Jocelyn's accident taught me that lesson in a pretty harsh way. Even if making love got Angie past the mental block, there are no guarantees she'd have a successful marriage or be a good mom. But isn't that true about me, too? And anyone, for that matter? There are no guarantees of a happy marriage or of kids, no matter what your intentions might be."
"All that is true, but Angie is stable and in a place where she can thrive and be successful."
"And be depressed because she can't teach or marry or have children."
"You're seriously considering her request?"
"I'd be a terrible friend if I wasn't considering it," I replied. "But taking the request seriously doesn't mean I'm going to do it! I have my OWN obstacles, which basically preclude me from doing it. If I made love with Angie, I'd be giving up Elizaveta and my ordination, and despite what Angie said, I'd be locking myself into a relationship with her, one which would be fraught with all sorts of risks because of my limited ability to provide strong emotional support for the next six or seven years."
"Thank heaven for small favors," Doctor Mercer said.
"I also didn't say I wasn't going to do it," I said quietly. "I love her, Doctor Mercer. And THAT is the ultimate source of the problem, if you will, at least from my perspective. You don't know this, but the people closest to me all say Angie is the one who should have been my wife and would have been except for her condition. And I agree with them. I was ready to commit to her during Freshman year, even if it meant four years of chastity before we could marry."
"Your heart and mind are in serious conflict."
"And my soul, too. Or better, what we call the «νοῦς» (nous). In effect, it's an admission that pure reason is insufficient and that there will always be mysteries which escape analysis and which really can't be expressed. It's the unknowable depth of a thing which constitutes its true, indefinable essence and reflects God as the source of its existence. We only understand these things by faith and intuitive truth — by the 'eyes of the soul', or the «νοῦς» (nous). This is the true center of a person and is true spiritual knowledge."
"Heart, mind, and soul seem almost Trinitarian," she observed.
"Yes, and the «νοῦς» (nous) is the example of God's energies and essence working together in me."
"So what do these three, in conflict, tell you to do?"
"My heart says make love to Angie and try to build a relationship with her. My mind says that's nuts, if you'll pardon the expression. My «νοῦς» (nous) says to heed my calling. The problem is, I have three callings — as a physician, as a clergyman, and as a husband and father."
"I think you'll find your resolution there, which actually doesn't surprise me at all."
"Angie can't fulfill my needs, and I can't fulfill hers, if I'm true to all three of my callings."
"Can the young woman you're going to ask to marry you fulfill them? And can you fulfill her needs while heeding those callings?"
"Yes."
"Then why the struggle?"
"Because I'm human! And I'm weak! And I let my desires control me! God gave me Free Will, and I have a great propensity to abuse it!"
Doctor Mercer laughed softly, "Sorry, I didn't mean to laugh, but your self-assessments are accurate and the way you express them is amusing."
"Trust me, Doc, I know my weaknesses. I am extremely susceptible to offers of physical intimacy from sexy redheads with green eyes and great bodies! Even more so if I happen to be in love with them!"
Doctor Mercer laughed again, "I do believe that is the common condition of straight college-age males everywhere!"
"And lesbians," I chuckled. "They seem to like redheads with green eyes as well!"
"I suspect you're right. But sexual attraction is not sufficient to take the kinds of risks you're talking about. And I'm not sure love is, either."
"Don't you think Angie deserves the chance to be truly happy? To have what her heart desires the most?"
"Yes, of course! But at what price? And at what risk? Do you really think she's in a state to make that kind of decision?"
"Am I? Are you?"
"You know, you're getting pretty good at that rhetorical method."
"As I've said, blame my mom; she taught me."
"But rhetoric is a teaching method, NOT a way to solve problems, per se. You can make a good logical argument and still be wrong. You can ask all the right questions and come up with the wrong answers. Marx did a pretty good analysis of the problems of capitalism, but I daresay you disagree with his proposed solutions."
"You could dare to say that," I replied.
"You remind me VERY much of another patient, and all I can say is that I'm glad your decision-making is better."
"Trying to flatter me into the result you want?" I asked.
"Flattery, rhetoric, beatings with a baseball bat or tire iron; whatever works!"
"Fair enough, given how blockheaded I can be at times. But you understand my true concern here is for the healing of Angie's soul and her salvation. I know that sounds odd, especially given that we're talking about sex, but in the end, the only question I can really ask is what is the best for Angie's salvation."
"I swear, if you say that you need to have sex with her to save her soul, I AM going to brain you!"
"It wouldn't be the physical joining of bodies, but the joining of souls — truly becoming 'one flesh'."
Doctor Mercer sighed, "What do you intend to do?"
"Go back to school, talk it over with my closest confidante, and then ask Elizaveta to marry me a week from Saturday."
"I have to say you are a very interesting study."
"How so?"
"Because you just spent fifteen minutes trying to argue me into agreeing with you."
"Did I?" I asked. "Or was I arguing with myself and using you as the foil, so to speak?"
"I don't see that very often in patients."
"Is that what I am? A patient?"
Doctor Mercer laughed softly, "I specifically told you that you weren't, didn't I?"
"Yes. Insofar as is possible, given my lack of training, we're collaborating on helping Angie. We just had a debate about the best course of treatment. You won."
"I'm not sure 'win' is the right way to describe it."
"Your position prevailed because, in the end, it's the one that provides for a relatively good outcome with minimal risk and, given the range of potential outcomes, is the one that is in Angie's overall best interest, even if it's not perfect."
"And that's your lesson for the future, Mike."
"Yes, but the perfect is NOT the enemy of the good; only Satan would suggest it is. We strive for perfection, even if we can't achieve it, but we have to strive; we can't use lack of perfection for indecision or non-action. I would love to find a course of action which resolved all of Angie's troubles with an acceptable level of risk, and maybe someday we will. But the solution she proposed today certainly isn't it."
"I was reasonably certain you were going to leave here with the intention of doing what she asked."
"That's because there was a real chance that was what was going to happen, despite what it might have cost me."
"You wouldn't be the first or last person to do something that wasn't in your best interest in order to help someone. BUT, you have to be sure the price you pay is worth the result you hope to obtain, and, if you're honest with yourself, with the cost of failure."
"True."
"What are you planning in the way of pre-marital counseling?"
"I hadn't thought that far ahead," I replied. "At least on that topic."
"I want to offer my services. Bring her to see me if that will work for you. I promise no attempts to persuade her to call things off. Your student health insurance should cover part of the counseling, and we'll figure out something reasonable for the remainder."
"It covers pre-marital counseling?"
"It covers relationship and adjustment counseling, and I daresay nobody will argue with me on the need for a pre-med student to have counseling."
"You were just LOOKING for a way to turn me into a patient," I teased.
"You did lie down on my couch!"
"True."
"How's your stress level?"
"Better, though my usual form of stress relief isn't available for another eight months!"
"How are you doing in that regard? And no snarky responses, please."
"There has been some temptation, but only because of a specific set of circumstances."
"Could those arise again?"
"I don't see how."
"Angie?"
"No. It was because of Lara. We agreed not to sleep together until we decided our future, and she asked me not to sleep with anyone else if I wasn't sleeping with her. She asked me to sleep with her over Labor Day weekend, and I turned her down because we weren't ready for that. When we concluded we weren't going to marry, she asked to end our relationship the way we'd begun it. Before I decided what to do, another young woman offered what she called a 'sleepover', which really tempted me. But in the end, the fact that I was also seeing Elizaveta and had told my priest I was acting chastely, I said 'no' to Lara."
"Thank God," Doctor Mercer said under her breath.
I chuckled, "I'm guessing you have at least one patient who would have taken both women up on their offers?"
"You could say that. You're a bit more self-controlled."
"Only a bit," I chuckled. "I've been a bit more promiscuous than I might have let on."
"And how do you feel about that?"
"It was a result of flawed thinking — that once I'd had one casual relationship, it didn't matter. I was wrong."
"Do you feel guilty?"
"I'm neither Roman Catholic nor Jewish," I grinned. "So, no."
"Smart aleck!" Doctor Mercer said with a laugh.
"I think the best thing to say is that I feel regret for my inability to remain chaste, but know that God forgives my transgressions, so as the prayer the priest says after confession, I 'have no further care for the sins which I have committed'."
"But you do, obviously?"
"In the sense that I know I failed to live up to perfection, yes, but not in the sense that I'm beating myself up for it."
"I think you'll find that your experience isn't all that different from other young adults who go away to college, even religious ones."
"Oh, I know," I replied. "My priest made that point when I first confessed fornication. But that's no excuse."
"No, it's not, but it is representative of the human condition. I believe you told me that the older ladies in the church had a solution for that."
"And YOU told me you disagreed with it!"
"In most instances, yes."
"Elizaveta turns sixteen in April," I said. "Are you sure you're the right person for pre-marital counseling?"
"She's fifteen?!" Doctor Mercer asked, sounding shocked.
"If she's going to be sixteen in April, it does follow that she's fifteen."
"Mike, don't be flip, please. She is VERY young."
"Yes, she is, but as was pointed out by several people, when I'm sixty, she'll be fifty-four."
"Sophistry, Mike."
"Do you think it's possible for someone to be mature enough to make this decision at fifteen?"
"Possible? Yes. But even if she's mature enough, the lack of life experience presents a host of potential problems."
"This is what she wants, Doctor Mercer. She approached me, made her case, and I began by having dinner with her dad, and then having a meal at her house each week. I had my concerns at first, but I'm certain I meet all her requirements just as she meets all of mine. This is, in effect, an arranged marriage, even though we more or less arranged it ourselves. Her parents, grandparents, the ladies in the church, my priest, and my bishop have all given their blessing."
"Which is irrelevant if she's not truly ready to make the kind of commitment you're asking her to make."
"That's backwards, Doc," I said, sitting up. "She's asking ME to make the commitment. She did her due diligence, if you will, by talking to a priest's wife, a deacon's wife, a doctor's wife, and her godmother. And she did that before she approached me with the idea."
"If you dated for another three years, I'd be a lot more comfortable with this situation."
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